| NPI | 1063643849 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 189147) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NC 5004421) |
| Enumeration Date | 2009-07-28 |
| Last Update Date | 2014-11-11 |